Republicans roll the political dice on health care

By Ricardo Alonso-Zaldivar

Published 7:41 pm, Sunday, June 11, 2017

WASHINGTON — Republicans are taking a big political risk on health care.

They’re trying to scale back major benefit programs being used by millions of people. And they’re trying to do it even though much of the public is leery of drastic changes, and there’s no support outside the GOP.

It’s not stopping them.

After seven years attacking former President Barack Obama’s health care law, Republicans are finally in control of the entire government and say they have to deliver now. Yet they’re not talking much about the trade-offs that come with sweeping changes, not to mention estimates that millions more people could be uninsured.

“I don’t think anything of this consequence has ever been passed in the entitlement arena,” said Jim Capretta, a health policy expert with American Enterprise Institute, a business-oriented think tank. “It’s a piece of legislation that would be highly consequential.”

Unprecedented “is a perfectly fair characterization,” said Lanhee Chen, who was policy adviser to former GOP presidential nominee Mitt Romney. Like Capretta, Chen agrees with the general direction congressional Republicans are taking, if not all the specifics.

Senate Republicans are winnowing down policy options in search of 51 votes to advance House-passed legislation this summer.

Health care programs usually grow faster than other government services. Republicans want to break that decades-long trend, although they’d leave Medicare largely untouched for now.

The talk is all about repealing the 2010 Affordable Care Act. But the GOP’s American Health Care Act would have lasting impact on Medicaid, the federal-state program covering about 70 million low-income and disabled people, including many elderly nursing home residents.

Republicans would phase out financing that the Obama-era law provides states that expand Medicaid to cover low-income adults. More significantly, the GOP would limit future federal spending for the broader program. Medicaid has been an open-ended entitlement, with the feds matching part of what every state spends, about 60 percent on average.

The House-passed GOP bill would cut $834 billion from projected federal Medicaid spending over a decade, leading to a reduction of about 17 percent in people covered by the program, according to the Congressional Budget Office.

“There is no capacity at the state level to pick up the slack if the federal government withdraws its commitment,” said Sen. Ben Cardin, D-Md.

“There are critical, life-changing decisions being made about Americans’ health care right now in the United States Senate that should have people on high alert,” Sen. Ron Wyden, D-Ore., said in this weekend’s Democratic radio address. “This legislation is going to put the health of millions of Americans at risk.”